HOMEPAGE – CASES DETAILS

Ankylosing Spondylitis (AS) with Additional Details

December 15, 2024

Patient History:

Ahmed Raza, a 28-year-old IT professional, presented to Dr. Ali Imran with a chief complaint of severe lower back pain and stiffness. He reported experiencing difficulty getting out of bed and moving around, especially in the mornings. These symptoms had been progressively worsening for over a year.

Challenges in Diagnosis:

Initially, Ahmed’s condition was misdiagnosed as a simple back strain. This is because ankylosing spondylitis (AS) can mimic other musculoskeletal problems, particularly in their early stages.  

Diagnostic Workup:

To obtain a more accurate diagnosis, Dr. Imran performed a thorough physical examination, focusing on:

  • Joint tenderness and swelling, particularly in the sacroiliac joints (lower back) and spine.
  • Range of motion in the spine and hips, looking for limitations caused by stiffness. 
  • The presence of the “Schober test,” which measures spinal flexibility.  

Advanced Imaging:

Dr. Imran also recognized the need for further investigation and ordered:

  • X-ray: This can reveal signs of inflammation and bone damage in the sacroiliac joints. 
  • MRI (Magnetic Resonance Imaging): This imaging technique provides a more detailed picture of the joints and soft tissues, potentially showing early signs of inflammation and structural changes in the spine characteristic of AS.

Confirmation of Diagnosis:

Based on the clinical presentation and the results of the imaging tests, Dr. Imran diagnosed Ahmed with Ankylosing Spondylitis.

Start of Treatment:

Understanding the chronic and inflammatory nature of AS, Dr. Imran developed a comprehensive treatment plan for Ahmed, including:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These medications help manage pain and inflammation.
    • It’s important to note that Dr. Imran would likely discuss potential side effects of NSAIDs with Ahmed, such as stomach ulcers, and monitor him for any complications.

     

  • TNF inhibitors: These are biologic drugs that target a specific inflammatory molecule involved in AS, aiming to slow disease progression and further reduce inflammation.  
  • Customized Exercise Regimen: A physical therapist plays a crucial role in creating a safe and effective exercise program to:
    • Improve and maintain spinal flexibility
    • Strengthen core muscles
    • Maintain good posture

Treatment Progress:

Ahmed diligently followed the treatment plan. Within four months, he experienced a significant improvement – a 70% reduction in pain and morning stiffness. This allowed him to move with greater ease and participate in daily activities with less difficulty.

By the ninth month, Ahmed successfully returned to his regular work routine at his IT job. He even felt confident enough to resume light physical activities, likely with guidance from his physical therapist to ensure they wouldn’t aggravate his condition.

Conclusion:

Ahmed’s case exemplifies the significant impact of:

  • Accurate diagnosis: Early and correct identification of AS allows for prompt treatment and potentially slows disease progression.  
  • Advanced imaging techniques: X-rays and MRIs play a vital role in confirming diagnosis and assessing disease activity.
  • Patient education: Understanding AS and its management empowers patients like Ahmed to actively participate in their treatment plan.
  • Holistic treatment approach: Combining medication, physical therapy, and potentially lifestyle modifications can significantly improve quality of life for patients with AS.
What Are My Options for Treatment
Ahmed’s case highlights the importance of a comprehensive approach to managing Ankylosing Spondylitis. Early diagnosis, advanced imaging techniques, patient education, and a multi-disciplinary treatment plan are crucial for optimizing patient outcomes. It was rewarding to see Ahmed regain his quality of life and return to his desired activities.

Patient Info:

Patient Name

Mr. Ahmed Raza

Age

28 Years

address

Multan, Punjab

Phone

03216543210

email

ahmed.raza28@example.com